Definiciones del Programa de Asistencia Médica en Dakota del Sur

Explicación Simple

Esta ley explica qué significan algunas palabras importantes en el programa de ayuda médica del estado. Por ejemplo, un 'beneficio' es algo que el estado te da para ayudarte con tus gastos médicos.

Es como cuando en un juego de mesa tienes que conocer las reglas para jugar bien. Sin saber qué significa cada término, es difícil entender cómo funciona el juego.

Ejemplo Práctico

Imagina que María necesita una operación y tiene un seguro médico del estado. Según esta ley, el seguro le dará 'beneficios' para cubrir parte de los costos, y su médico, que es el 'proveedor', debe enviar un 'reclamo' para que el estado le pague.

Texto Original del Estatuto (Inglés)

HomeLegislatorsSessionInterimLawsAdministrative RulesBudgetStudentsReferencesMyLRC +SearchCodified LawsCodified LawsCodified LawsHome>Codified Laws>22>45>1PreviousNextGo To:(1-1-1) or Google SearchPrinter Friendly22-45-1.Definition of terms.Terms as used in this chapter mean:(1)    "Benefit," any benefit authorized under the medical services program of the State Department of Social Services;(2)    "Claim," any communication, whether oral, written, electronic, or magnetic, which is utilized to identify a good, item, or service as reimbursable under the program;(3)    "Person," any individual, corporation, limited liability company, partnership, association, or other legal entity;(4)    "Program," the medical assistance program authorized by Title XIX of the Federal Social Security Act and implemented by the medical services program of the State Department of Social Services;(5)    "Provider," any person who has applied to participate or who participates in the program as a provider of a good or a service;(6)    "Recipient," any individual who receives benefits under the program;(7)    "Records," any medical, professional, or business records relative to the treatment or care of any recipient, or to a good or a service provided to any such recipient, or to rates paid for such a good or a service, and any records required to be kept by regulations of the program;(8)    "Sign," to affix a signature directly or indirectly by means of handwriting, typewriter, signature stamp, computer impulse, or other means; and(9)    "Single state agency," the state agency which administers the program, or any person who by virtue of a contract or agreement with the state administers any part of the program, or processes or pays claims for the program.Source:SL 1986, ch 187, § 1;SL 1994, c